Topic Overview

Long-acting opioid pain relievers are medicines used to relieve moderate to severe long-term pain. They are also called extended-release or sustained-release (SR) opioids. Opioids relieve pain by changing the way your body feels pain. They don't cure a health problem, but they help you manage the pain.

If you take multiple daily doses of short-acting medicine, your doctor may give you long-acting opioids as an alternative. Long-acting opioids will provide you with more consistent pain relief.

Opioids are strong medicines. They can help you manage pain when you use them the right way. But if you misuse them, they can cause serious harm and even death.

If you decide to take opioids, here are some things to remember.

• Keep your doctor informed. You can develop opioid use disorder. Moderate to severe opioid use disorder is sometimes called addiction. The risk is higher if you have a history of substance use. Your doctor will monitor you closely for signs of opioid use disorder and to figure out when you no longer need to take opioids.
• Make a treatment plan. The goal of your plan is to be able to function and do the things you need to do, even if you still have some pain. You might be able to manage your pain with other non-opioid options like physiotherapy, relaxation, or over-the-counter pain medicines.
• Be aware of the side effects. Opioids can cause serious side effects, such as constipation, dry mouth, and nausea. And over time, you may need a higher dose to get pain relief. This is called tolerance. Your body also gets used to opioids. This is called physical dependence. If you suddenly stop taking them, you may have withdrawal symptoms.

Examples of long-acting opioids

• Morphine ER (Kadian), Morphine SR (MS Contin) 
• Fentanyl patch (Duragesic)
• Methadone (Metadol)
• Oxycodone controlled-release (OxyNeo, Targin)
• Hydromorphone (Hydromorph Contin)

Safety tips when using long-acting opioids

If you need to take opioids to manage your pain, remember these safety tips.

• Follow directions carefully. It's easy to misuse opioids if you take a dose other than what's prescribed by your doctor. This can lead to overdose and even death. Even sharing them with someone they weren't meant for is misuse.
• Be cautious. Opioids may affect your judgment and decision making. Do not drive or operate machinery until you can think clearly. Talk with your doctor or pharmacist about when it is safe to drive.
• Reduce the risk of drug interactions. Opioids can be dangerous if you take them with alcohol or with certain drugs like sleeping pills and muscle relaxers. Make sure your doctor knows about all the other medicines you take, including over-the-counter medicines and natural health products. Don't start any new medicines before you talk to your doctor or pharmacist.
• Keep others safe. Store opioids in a safe and secure place. Make sure that pets, children, friends, and family can't get to them. When you're done using opioids, make sure to properly dispose of them. You can either use a community drug take-back program or return the medicine to the pharmacy. Do not flush medicines down the sink or toilet.
• Reduce the risk of overdose. Misuse of opioids can be very dangerous. Protect yourself by asking your doctor or pharmacist about a naloxone rescue kit. It can help you-and even save your life-if you take too much of an opioid. You can get a naloxone rescue kit without a prescription at most drugstores.

Possible side effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. You may:

Here are some important things to think about:
• Usually the benefits of the medicine are more important than any minor side effects.
• Side effects may go away after you take the medicine for a while.
• If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to. 

Call 9-1-1 or your local emergency service right away if you have:

• Trouble breathing.
• Swelling of your face, lips, tongue, or throat.
• Signs of an overdose, including:   
  • Cold, clammy skin.
  • Confusion.
  • Severe nervousness or restlessness.
  • Severe dizziness, drowsiness, or weakness.
  • Slow breathing.
  • Seizures. 

Call your doctor if you have:

• Hives.
• A fast, slow, or pounding heartbeat.
• Increased sweating.
• Redness or flushing of the face.